Differences Between Glycemia Estimates from Hemoglobin A1c and Continuous Glucose Monitoring and Their Association with Complete Blood Counts

作者：Veronica Tozzo, David M. Nathan, Heidi Krause‐Steinrauf, John M. Lachin, Mary E. Larkin, Christopher Mow, Nicole Butera, Robert M. Cohen, John M. Higgins · 发表于：Diabetes Technology & Therapeutics · 年份：2025 · DOI：10.1177/15209156251395036 · 被引用次数：1 · 研究领域：Diabetes Management and Research、Diabetes, Cardiovascular Risks, and Lipoproteins、Hyperglycemia and glycemic control in critically ill and hospitalized patients

Objective: Continuous glucose monitoring (CGM) and hemoglobin A1c (HbA1c) provide estimates of mean glycemia that may differ, in part, due to the effects of variation in red blood cell (RBC) age and turnover on HbA1c. Measurements derived from the complete blood count (CBC) may vary with RBC age and might be used to reduce the difference between glycemia estimates derived from CGM and HbA1c. Methods: We analyzed CBC measurements from 1,325 individuals with type 2 diabetes who participated in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE) CGM substudy. Mean glycemia was estimated from HbA1c (eAG A1c ) using the A1c-Derived Average Glucose (ADAG) formula and from CGM by averaging 10 days of measurements (eAG CGM ). We evaluated the association between CBC-derived data and the difference (eAG A1c − eAG CGM ) using linear models, both unadjusted and adjusted for age and self-identified sex. Results: In adjusted analyses, several CBC-derived measurements were significantly associated with the difference between eAG A1c and eAG CGM . Platelet count and RBC distribution width (RDW) were positively associated, while hemoglobin concentration (HGB), reticulocyte fraction, mean corpuscular volume (MCV), mean corpuscular hemoglobin content (MCH), mean corpuscular hemoglobin concentration (MCHC), and reticulocyte MCHC were negatively associated. A linear model from HbA1c to eAG CGM adjusted with all significantly associated CBC measurements (CBC a...